A deficiency and 293 million children in the same age group have anaemia. Member States have requested guidance from the World Health Organization (WHO) on the effects and safety of the use multiple micronutrient powders for home fortification of foods consumed by infants and children 6–23 months of age in support of their efforts to achieve the Millennium Development Goals. WHO has developed the present evidence-informed recommendations using the procedures outlined in the WHO handbook for guideline development.

The steps in this process included:

(i) identification of priority questions and outcomes; (ii) retrieval of the evidence; (iii) assessment and synthesis of the evidence; (iv) formulation of recommendations, including research priorities; and (v) planning for dissemination, implementation, impact evaluation and updating of the guideline. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology was used to prepare evidence profiles related to preselected topics, based on up-todate systematic reviews. The guideline development group for nutrition interventions, the Nutrition Guidance Expert Advisory Group (NUGAG), comprises content experts, methodologists, representatives of potential stakeholders, and consumers. These experts participated in several WHO technical consultations concerning this guideline, held in Geneva, Switzerland, and Amman, Jordan, in 2010 and 2011. Members of the External Experts and Stakeholders Panel were identified through a public call for comments, and the panel was involved throughout the guideline development process. NUGAG members voted on the strength of the recommendation, taking into consideration: (i) desirable and undesirable effects of the intervention; (ii) the quality of the available evidence; (iii) values and preferences related to the intervention in different settings; and (iv) the cost of options available to health-care workers in different settings. All NUGAG members completed a Declaration of Interests Form before each meeting. Home fortification of foods with micronutrient powders containing at least iron, vitamin A and zinc is recommended to improve iron status and reduce anaemia among infants and children 6–23 months of age (strong recommendation). The overall quality of the evidence for iron deficiency was found to be high, whereas for anaemia, haemoglobin concentration, iron status and growth it was moderate. Ideally, interventions with multiple micronutrient powders should be implemented as part of a national infant and young child feeding programme.